Oral Cancer News
Compiled by The Oral Cancer Foundation

throat cancer

What men can do about HPV

Michael Douglas caught major flak for saying oral sex gave him throat cancer. But if you’re laughing, it’s time to grow up. Oral cancers caused by the sexually transmitted human papillomavirus (HPV) have skyrocketed 225 percent in the past 15 years, with men accounting for 75 percent of all cases. The number-one culprit: HPV passed via oral sex.

It used to be that cigarettes caused most of these cancers. But since smoking rates have plummeted over the past few decades, and we’re having way more oral sex today than even our fathers’ generation, HPV has become the most common STD in the U.S. – inevitably leading to more oral cancer cases. It only takes one time going down on someone to contract HPV, and experts estimate that 80 percent of us will be exposed to the virus at some point in our lives. This STD sometimes causes genital warts, but according to the Centers for Disease Control and Prevention, that’s not very common. In most cases, HPV has no symptoms. And since no test exists to detect HPV in guys, you won’t know you have the virus until years later – if it turns into cancer.

“It’s very hard to determine when you acquired HPV,” says Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University. “It doesn’t usually come from just one sexual episode. That said, every once in a while, cancer develops within two years of when you think you acquired HPV. But most often it comes 10, 12, even 20 years later.”

Still, not all HPV cases lead to oral cancer. Far from it. So even though the rapidly rising prevalence of these cancers is scary – and nothing we should take lightly – we need to keep the actual risk in perspective. “It’s true that within the world of oral cancer, HPV-caused cases have become an epidemic,” says Brian Hill, executive director of the Oral Cancer Foundation. “They are rapidly increasing at a rate never seen before, and it’s going to get much worse by 2020. However, in the grand scope of the U.S. population, the term ‘epidemic’ is overstating the reality. Only a small percentage of sexually active people wind up with an HPV-related oral cancer. For 99 percent of those who get HPV, their immune system clears it within 12 to 24 months, and that’s that. So we have to look at the relative risk. Don’t stop having sex. That’s not an appropriate response.”

So what is the right response? To protect yourself without killing your sex life, there are HPV vaccines like Gardisil. These are proven to protect against HPV-caused anal and cervical cancers, and doctors overwhelmingly believe they also prevent oral cancers. However, the CDC recommends vaccination only for men under age 26, and most insurance plans won’t cover it for older guys. Still, that doesn’t necessarily mean you should rule out the vaccine if you’re past 26.

“The CDC’s recommendations are based on a generality,” Schaffner says. “Statistics show that most guys, by age 26, have had multiple sexual partners and have probably been exposed to HPV. But every individual is different. A guy may have been in a long-term monogamous relationship that’s ended, and now he’s reentering the social scene and going to have sex. It won’t do him any harm to get immunized. Insurance probably won’t cover the vaccine, but he can certainly pay the $300 to $400 out of pocket.”

But if you’ve had a handful of partners – and, if the stats are correct, have probably already come in contact with HPV – the decision boils down to whether you want that extra piece of mind, says Schaffner. After all, you could be one of the lucky few who’s had lots of sex but never been exposed. “It’s kind of like wearing a belt and suspenders,” he explains. “Wearing both may be unnecessary, but at least can be sure your pants won’t fall down. By getting the vaccine, you know you’ve done everything you can to protect yourself from HPV.”

Besides being immunized, which only spares you from HPV if you haven’t been exposed, you should limit your sexual partners and always use protection. But even then, condoms and dental dams aren’t surefire HPV blockers, Schaffner says, because you can get the virus from skin-to-skin contact. “HPV can be present on the penis shaft and vaginal lips, not just on mucus membranes, semen, or vaginal fluid,” he says. “Therefore, condoms – both male and female types – are very helpful, but they don’t offer complete protection, even if they’re used as directed and don’t break.”

Schaffner says gay men aren’t necessarily at less risk of oral cancer just because they’re not performing oral sex on women. It has more to do with how often a guy has sex and how many different men he’s slept with. However, the CDC says gay and bisexual men are 17 times more likely to develop anal cancer – also caused by HPV – than men who only sleep with women.

Even if you already have HPV – and don’t know it – you can take steps to decrease your chances of oral cancer. Schaffner says to stop smoking immediately and cut back on booze. “We’re not sure why, but smoking and drinking too much both increase HPV’s likelihood of developing into cancer,” he explains.

To be safe, you should also be on the lookout for early signs of oral cancer, which tend to be subtle, so guys often ignore them, says Hill. Unlike tobacco-caused oral cancers, which present in visible symptoms like white lesions or red spots on the tongue, HPV-related cancer cells love lymph tissue and the way back of your tongue. “HPV-caused oral cancers have very stealthy signs, so you really have to pay attention if you feel changes,” he says.

Here’s what to look for: “If you notice it’s become more difficult to swallow, or you’re suddenly always hoarse or have a sore throat, those are definite cancer red flags, and you need to get examined,” Hill says. “Also, if a lymph node in your neck becomes enlarged – and it’s painless – that’s a warning sign of cancer starting inside the mouth and spreading to your neck. When lymph nodes swell up from ear infections or abscessed teeth, they hurt. But these ones don’t. And if you can’t push it around, that’s a definite sign.”

Thankfully, all you dads and future fathers can help spare your sons from these health issues. Get them vaccinated long before they wind up going down on a girl in the back seat of your car. “Don’t put it off until they’re 17,” Schaffner says. “Have them immunized when they’re 11.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

By Agence France-PresseTuesday, June 4, 2013 18:40 EDTSource: The Raw Story

Michael Douglas said he would win a Nobel prize if he knew exactly what caused his throat cancer, in fresh comments Tuesday after a dispute with a British newspaper over an interview he gave.

The “Fatal Attraction” star, whose spokesman already denied he blamed his throat cancer specifically on oral sex, also said that, regardless, he was happy to raise awareness about causes of the killer disease.

“I never expected to become a poster boy for head and neck cancer,” Douglas said in comments issued by a representative.

“But, if after what started out as trying to answer a couple of questions about the suspected sources of this disease results in opening up discussion and furthering public awareness, then I’ll stand by that.”

In an interview with Britain’s Guardian newspaper, Douglas, who stars in the just-released biopic of flamboyant entertainer Liberace, “Behind The Candelabra,” said his cancer was caused by the human papillomavirus (HPV).

“Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus,” he said, in comments the newspaper said amounted to blaming oral sex for his cancer.

Douglas’s spokesman Allen Burry said Monday that the 68-year-old actor was talking in general, not personal terms.

“This is not the cause of his cancer,” he said.

On Tuesday, Douglas himself added: “Head and neck cancer can be caused by many things including HPV virus, smoking, alcohol, drug abuse, genes, environment and stress. I do not know what caused my particular cancer.”

“If I did I’d have a Nobel Prize. I do know that I am here today because of all the incredible advances in cancer research and treatment. Early awareness is a key factor.”

“If this episode contributes to public awareness, all the better,” he said.

The British newspaper stuck to its guns over the issue, posted an audio clip of the interview on its website and insisted that Douglas had been referring to his own cancer being caused by cunnilingus.

“The Guardian firmly denies this charge of misrepresentation. Mr Burry was not present at the (interview); the only two people present were Mr Douglas and the Guardian writer, Xan Brooks,” the paper noted online.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Douglas, now 68, was diagnosed with a “walnut-sized” stage IV tumor at the base of his tongue in 2010 after months of oral discomfort. His well-known tobacco and alcohol habits — both risk factors for oropharyngeal cancers — had been thought to be the cause, but he appeared to indicate otherwise in an interview appearing in British tabloid The Guardian yesterday.

While one of his representatives has since challenged that interpretation of the interview, the spotlight on HPV as a cause of cancer should promote awareness of the need for HPV vaccination, head and neck cancer and HPV specialists contacted here at the American Society of Clinical Oncology meeting said.

“It’s no surprise to physicians such as myself, because probably 80% of the tonsil and tongue cancers I see are related to HPV,” Eric Moore, MD, an oropharyngeal cancer specialist at the Mayo Clinic in Rochester, Minn., noted in an interview with MedPage Today.

Most adults become exposed to the virus at some point but clear it like any other infection. Those who become chronically infected are at elevated risk of cervical, anal, and head and neck cancers, particularly from subtype 16.

The tonsils and base of tongue are the predominant areas affected in the head and neck because of the deep pockets in the tissue there that allows the virus a foothold, similar to the cervix, Moore explained.

Oral sexual contact is how HPV is thought to spread to the mouth and throat, and men appear to more readily acquire the virus from women than women do from men, as is true in other sexually transmitted infections, noted William Schaffner, MD, an infectious diseases specialist at Vanderbilt University in Nashville, Tenn.

While many patients worry about who they may have gotten the virus from and who they have given it to, clinicians can reassure patients that testing family members and partners isn’t necessary.

“It’s impossible to know in people with multiple sexual partners how they got it,” he said. “If you went back and tested their partners, you wouldn’t even know because they may have cleared the infection.”

Moreover, there isn’t an established and reliable test for oral HPV unlike for the cervix.

Examination of the mouth, tongue, and head and neck lymph nodes during a dental exam should help catch oropharyngeal cancers at an early stage, Schaffner noted.

But there isn’t a treatment for chronic HPV infection or any evidence supporting HPV testing for nonsymptomatic individuals, added Marcia Brose, MD, PhD, a head and neck cancer specialist at the Abramson Cancer Center in Philadelphia.

“We’re not even near that yet,” she told MedPage Today.

But those considerations make prevention all the more important, and for that reason public awareness of Douglas’ case could be helpful, Schaffner said.

“It will generate many conversations,” he said. “I don’t believe it will change a great deal of behavior, but certainly knowledge that HPV is increasing and HPV is a cause of cancers may make understandable CDC recommendation that all children should be vaccinated against HPV.”

Brose and Moore agreed that physicians can take advantage of conversations about HPV- and oral-sex-related risk to promote vaccination of adolescents.

“It’s not as clear cut whether adults should be vaccinated,” Moore noted. “After you’ve already seen the virus, the vaccine doesn’t work because you’ve already been ‘auto-vaccinated’ by clearing the virus.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

On Sunday, in an interview with the Guardian, actor Michael Douglas revealed that his throat cancer was not caused by tobacco and alcohol, but by HPV, which was transmitted through oral sex. He has since called the statement a misunderstanding, but it’s still true: you can get throat cancer from HPV.

In an eye-poppingly candid interview with the Guardian’s Xan Brooks, Douglas, who is married to actress Catherine Zeta-Jones, allegedly told the reporter his cancer was caused by the STD:

The throat cancer, I assume, was first seeded during those wild middle years, when he drank like a fish and smoked like the devil. Looking back, knowing what he knows now, does he feel he overloaded his system?

“No,” he says. “No. Because, without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus.”

From what? For a moment I think that I may have misheard.

“From cunnilingus. I mean, I did worry if the stress caused by my son’s incarceration didn’t help trigger it. But yeah, it’s a sexually transmitted disease that causes cancer.” He shrugs. “And if you have it, cunnilingus is also the best cure for it.”

Right, I say. OK. So what he is suggesting is that it all evens out? “That’s right,” says Douglas. “It giveth and it taketh.”

Human papillomavirus (HPV) is a sexually transmitted disease that can cause genital warts or present itself without symptoms. If left untreated, it can also cause cancers of the cervix, anus, penis, vulva, vagina — and head and neck cancers. “HPV being a cause of head and neck cancer was really only accepted about five years ago,” says Dr. Maura Gillison, a professor at the Ohio State University who studies HPV infections in the head, throat and neck. “Before then, no one really cared about oral HPV infections.”

According to the U.S. Centers for Disease Control and Prevention, about 60% of oropharyngeal cancers — cancers of the throat, tonsils and the base of tongue — are related to HPV. It is estimated that every year in the U.S., more than 2,370 new cases of HPV-related oropharyngeal cancers are diagnosed in women and about 9,356 are diagnosed in men; they are most common in white men.

“It is a known phenomenon,” says Gillison. “In the U.S., there is an active shift going on. Fortunately thanks to tobacco policy and public-health awareness, the incidence rate for the classical head and neck cancer caused by smoking is declining. But unfortunately, the rate of oropharynx cancer is still going up and it’s because of the HPV component.”

In 2011, Gillison and her colleagues conducted a study looking at the proportion of oropharynx cancers associated with HPV over time in the U.S. The proportion increased from 16% to 72% from the late 1980s to the early 2000s. “The incidence is rising pretty rapidly in the U.S.,” says Gillison. “Approximately 10% per year, particularly among Caucasian middle-age men.”

HPV-related throat cancer presents similarly to tobacco- and alcohol-related throat cancer, but they are considered two separate diseases, says Gillison. There are about 15 different HPV types that are established causes of cancer. The most common are HPV 16 and 18, accounting for about 70% of cervical cancers. “For oral infection, we find the same types of HPV in the oral cavity as we do in the cervix or genital region for men, but the infection is considerably less common,” says Gillison.

Oral HPV doesn’t benefit from the comprehensive testing and preventative procedures established for HPV of the cervix. Women who get regular Pap smears are quickly tested for cancerous changes that may be caused by HPV of the cervix.

“When HPV was recognized to be the cause of cervical cancer, the entire algorithm for doing Pap smears and referring a patient to a gynecologist was already established,” says Gillison. “The researchers were able to just piggyback all of their analysis and testing for HPV on the cervix onto something that was already established in the field. For oral, there is no established screening algorithm so there is no piggybacking onto routine clinical care.”

There is currently no method to routinely test for oral HPV, nor is there a way to test men for genital HPV. Researchers are working on developing clinical tests for the virus, which is among the most common STDs: researchers say most sexually active people will likely have an HPV infection at some point, but many never know. The infection doesn’t always present symptoms, and typically clears the body in one to two years.

According to the Johns Hopkins School of Medicine, it is estimated that 20 million people in the U.S. currently have HPV infection, and 1 in 49 people will contract a new HPV infection each year.

Physicians recommend the HPV vaccine for both young boys and girls to prevent infection from the disease.

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Spouses and long-term partners of patients with mouth and throat cancers related to infection with the human papilloma virus (HPV) appear to have no increased prevalence of oral HPV infections, according to results of a multicenter, pilot study led by Johns Hopkins investigators. The study’s results suggest that long-term couples need not change their sexual practices, say the scientists.

“While we can’t guarantee that the partners of patients will not develop oral HPV infections or cancers, we can reassure them that our study found they had no increased prevalence of oral infections, which suggests their risk of HPV-related oral cancer remains low,” says Gypsyamber D’Souza, Ph.D., M.P.H., associate professor of epidemiology at the Johns Hopkins University Bloomberg School of Public Health. She is expected to present the results of her study June 1 at the 2013 American Society of Clinical Oncology Annual Meeting.

HPV-related oral cancers are rising in prevalence among white men in the United States, and fear of transmitting the virus can lead to anxiety, divorce, and curtailing of sex and intimacy among couples, says D’Souza. Persistent oral HPV infections are a risk for developing oropharyngeal cancers, located at the base of the tongue, tonsils, pharynx and soft palate.

At the Johns Hopkins Hospital and three other hospitals, researchers conducted surveys and took oral rinse samples from 166 male and female patients with HPV-related oropharyngeal cancers and 94 spouses and partners. The scientists also studied patients’ tumor samples and performed visual oral examinations of spouses/partners. Of the 94 spouses/partners, six were male.

More than half of patients had at least one type of HPV DNA detectable in their oral rinses, including HPV16, the viral type most commonly associated with oral and other cancers. After a year, only seven patients (six percent) still had oral HPV16 DNA detectable.

Of the 94 spouses/partners, six had oral HPV infections (6.5 percent). Among the six, none of the men and two of four females (2.3 percent) had HPV16 infections at very low levels. These infections were not detectable one year later. No oral cancers were detected among 60 spouses/partners who underwent a visual oral exam.

One spouse and one patient reported a history of cervical cancer. Two spouses reported a history of cervical pre-cancer, and three patients said they had previous spouses with cervical cancers, but these were self-reported, unconfirmed cases.

“The oral HPV prevalence among partners who participated in this study are comparable to rates observed among the general population,” says D’Souza. “We suspect that long-term spouses and partners have been exposed to HPV, like most of us, and appear to have cleared the virus.”

D’Souza and her colleagues recommend that long-term couples need not change their sexual practices. “Certainly, with new sexual partners, caution is always advised.”

More research is needed to determine the timeline of progression for HPV-related oral cancers and how HPV is transmitted and suppressed by the immune system, adds D’Souza.

Provided by Johns Hopkins University School of Medicine search and more info website

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

By: Sheryl Ubelacker, The Canadian Press, April 17, 2013Source: ottawacitizen.com

TORONTO – It was quite a shock for Rod Sinn when he learned the persistent sore throat he’d had for five months, initially diagnosed as tonsillitis, was actually an increasingly common form of throat cancer caused by the human papilloma virus.

Equally unpleasant was the news that the standard treatment for oropharyngeal cancer, which typically affects the back of the tongue, tonsils and nearby tissues, is radiation and chemotherapy.

Sinn, a physically fit non-smoker who only drinks alcohol occasionally, had seen what the double-barrelled treatment could do. A friend diagnosed with throat cancer a year earlier and given the standard treatment lost his salivary glands and sense of taste.

“I thought, wait a minute, there’s got to be another option. I really don’t like the side-effects of all that radiation,” the 52-year-old businessman, who lives in Oakville, Ont., near Toronto, said Tuesday.

After searching the Internet, he discovered doctors at Western University in London, Ont., were the only ones in Canada performing robotic-assisted surgery for throat cancer.

Sinn had the robotic surgery in spring 2011, plus a follow-up operation to remove some lymph nodes for testing to make sure his cancer hadn’t spread. While the surgery left him unable to swallow for several weeks and he lost some taste buds for a time, he is virtually back to normal except for some numbness in his neck where the lymph nodes were removed.

“It was fantastic,” said Sinn, who counts himself a believer in the surgery.

While it may be an end for Sinn — he said he “cried like a baby” after being told he was cancer-free two months after the treatment — it is just a beginning of sorts for his surgeon, Dr. Anthony Nichols.

With the help of a $223,000 grant from the Canadian Cancer Society, Nichols and radiation oncologist Dr. David Palma are conducting a three-year trial to determine whether robotic surgery is superior to standard treatment in curing the cancer and giving patients a better quality of life with fewer side-effects.

Since late 2010, the surgical team has performed about 40 of the robot-assisted operations.

The clinical trial, which now includes doctors at the University of Ottawa, will compare treatments in almost 70 patients, with half randomly selected for standard treatment using radiation, with or without chemotherapy, and the other half getting robotic surgery.

Although robotic-assisted operations for throat cancer are widely done in the United States, the researchers say there has been no clinical trial proving the surgery is better for patients.

“Before we can adopt a new treatment, we have to prove that the rates of cure are as good as they are with the standard treatment, which is chemotherapy with radiation,” said Palma, a clinician-scientist with the Ontario Institute for Cancer Research.

“Sometimes new technologies are introduced with a lot of hype but don’t prove to be helpful in the end. Transoral robotic surgery has shown tremendous promise as a treatment option, and we are the only ones in the world doing this type of study right now.”

Nichols said that in an era of cost-containment in health care, it’s critical to show that using the $2.5-million robots for the surgery is the right thing to do, “that we’re helping patients, not harming them.”

“Patients with HPV-related throat cancers tend to be younger and healthier and have a good chance of being cured. As they will have to live with the side effects of treatment for decades, post-treatment quality of life is of paramount importance.”

From a surgical point of view, minimally invasive robot-assisted procedures seem to be head and shoulders above standard surgery for throat cancer, which often involves making large incisions in the face and neck, even splitting the jaw to allow the surgeon access to the back of the throat.

Patients who have had this kind of surgery in the past are often left not only facially disfigured, but unable to swallow and dependent on a permanent feeding tube.

With the newer technique, doctors use tiny robotically controlled surgical implements to remove tumours of the tongue, tonsils, palate or throat. The robot has a viewfinder and 3-D camera that can see around corners, and the tiny robotic arms can get into tight spaces where the surgeon’s hands won’t fit.

While the surgeon watches what’s happening on a screen, the robotic arms precisely mimic the movements of the surgeon’s hands and can even filter out a surgeon’s hand tremor.

“To work in the back of the throat, around the back of the tongue and the voicebox is just a line of sight issue,” Nichols said. “You can’t see really well around that corner, down towards the esophagus. But if you can use an angled camera to overcome that, combined with the 3D viewer and magnification, it lets you see a lot easier.

“So it can make surgeries that are very challenging — and in some cases not possible through the mouth — now possible to do through the mouth.”

Nichols said in the past, most throat cancers were caused by heavy smoking combined with alcohol consumption. A dramatic reduction in smoking rates over the last few decades has resulted in a big drop in related oral cancer rates.

But in the last 10 to 20 years, there’s been a huge upswing in the number of cases caused by the human papilloma virus, or HPV, a sexually transmitted disease that can lead to throat cancer in some people two or even three decades after the initial infection.

In fact, HPV is linked to about 25 to 35 per cent of oropharyngeal cancers, and is also the major cause of cervical cancer in women.

“We’re seeing a veritable explosion,” said Nichols. “So each year, we’re seeing more and more of these patients and they have tumours in this exact location, which was otherwise hard to reach.”

Sinn doesn’t need to wait for the study results. He’s already made up his mind about robotic surgery.

“To me, it’s important to let the medical community know this is available,” he said. “I’ll be the guy standing in the corner waving the flag, saying: ‘Hey, this is fantastic.”

* OCF Note – The caveat to this story is that while there is little question that compared to the older surgical technique that this is far less invasive and the treatment related morbidity/ damage from it is definitely less- the big unknown will be; do these surgical only solution patients have the same disease free (no recurrence) years afterwards as those who get radiation and chemo. With some recurrences being reported out in patients more than the five year mark, it will take far longer than the time period indicated in this trial to know if surgery alone has the same long term curative rates as the current standard of care.

** This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Dallas star Larry Hagman, who played the scheming oil tycoon J.R. Ewing in the television soap opera, passed away last Friday, at the age of 81. The Dallas actor was suffering from throat cancer. Larry Hagman’s sudden death is being mourned by friends and family alike.

Brenda Strong was quoted as saying to E! News, “Being able to work with one of my childhood idols was a dream come true. He was one of the most resilient and positive people I’ve ever known. Larry’s tremendous talent and contribution as an artist is only surpassed by his gigantic heart and how beloved he was by his friends, especially Patrick and Linda.”

Larry Hagman rose to fame in 1965 when he was cast in the sitcom I Dream of Jeannie as astronaut Major Anthony Nelson. He then went onto become famous for his villainous role as J.R. Ewing on Dallas from 1978 to 1991.

Larry Hagman had once laughed off the idea of retiring, when he said, “I’d like to die onstage, so to speak. I love acting and I’ve had a wonderful career.”

Barbara Eden, Larry Hagman’s I Dream of Jeannie co-star said, “I still cannot completely express the shock and impact from the news that Larry Hagman has passed…I can honestly say that we’ve lost not just a great actor, not just a television icon, but an element of pure Americana. Goodbye Larry, there was no one like you before and there will never be anyone like you again.”

On Sept. 30, thousands of people will participate in the Run for the Cure marathon. They will raise thousands of dollars for breast cancer research. The Canadian Breast Cancer Foundation website is a sea of pink and purple and shows many further upcoming events where people can get involved in fighting breast cancer: The Nite of Hope auction, garden parties, the Pink Ribbon Charity Ball. The viewer is overwhelmed by the sheer volume of the support.

It reminds me of an email I received a few years ago from a dear friend who asked me to pledge support for a breast cancer walkathon. Her personal website stated that “together, we can beat breast cancer.” There were some stats on the disease, plus a little thermometer measuring how her pledges were doing.

Seeing the pink ribbons raises many emotions in me. And, to be honest, one of them is anger.

Please don’t get me wrong. I have more than a passing interest in breast cancer. I lost a dear sister-in-law to breast cancer. I have friends who live with the illness. I consider myself a lucky breast cancer survivor.

So why am I upset? Simple. I’m jealous of all the attention paid to breast cancer when there are so many other cancers that could also benefit from public awareness.

All cancers should be a priority.

My breast cancer was caught by a screening mammogram. After a biopsy confirmed an invasive lobular carcinoma, I underwent a partial mastectomy and underarm surgery, called an axillary dissection. This was followed by weeks of radiation and years of hormone therapy. Fingers crossed, so far so good.

The mammogram probably saved my life as the cancer was caught early, before it had a chance to spread. Mammograms are free for all women over 50. Tamoxifen, the tablet that gave me a shield against the possibility of a recurrence, is also free.

Yet while I am deeply grateful for all that the public healthcare system did for me, I am also deeply bitter about what it did not do for my sister who died five years ago of throat cancer.

Her life was shortened by decades. I don’t know if there is screening for throat cancer, but there certainly is a lack of public awareness, and even awareness among health professionals. Reading her diary was heartbreaking. Doctors ignored her repeated complaints of symptoms for about eight months, prescribing antibiotics and allergy meds to shut her up. By the time she was diagnosed, the tumour was very large and her two choices were horrendous: either undergo a horrific operation, with a 20% chance of dying under the knife and 100% guarantee of poor quality of life afterward, or accept palliative care, and try to enjoy the next six months. I miss her very much.

Ironically, throat cancer has a similarly positive prognosis to breast cancer if caught early. Both have a five-year survival rate in the 80% to 90% range. But without screening and awareness programs, the outcome is deadly.

I am also deeply concerned that 50% of the population — men — don’t get the same high-profile treatment that women do when it comes to cancer. While I am happy to be alive, I also have a husband and sons. I love them dearly and I don’t want them to die a preventable death from the disease.

Take prostate cancer, for example. It is more prevalent than breast cancer. It is at least as deadly as breast cancer when not caught early. But while mammograms are free, prostate PSA tests are not. Further, this screening test is sometimes discouraged. Some health-care professionals caution men about “false positive” results. A friend, who is also a doctor, didn’t have the PSA tests. He was very angry when his prostate cancer was discovered. It was advanced by then and the treatment was lengthy and severely impacted his quality of life. He felt betrayed by his own profession.

And don’t get me started about lung cancer. It is far more deadly than most other cancers. Most people don’t live long after their diagnosis. But if it were caught early, they might have a better chance at treatment prolonging and improving the quality of — if not outright saving — their lives. Where are the public screening and awareness programs for lung cancer?

Sadly, my girlfriend — the one who sent me the email about beating breast cancer — died of lung cancer.

Public awareness is vital in battling any illness. Breast cancer has set the gold standard for this. Now can we get on with it and make other cancers an equal priority?

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

I was Born in Salt Lake City, March 27th 1953. I died of Throat Cancer on July 10th 2012. I went to six different grade schools, then to Churchill, Skyline and the U of U. I loved school, Salt Lake City, the mountains, Utah.

I was a true Scientist. Electronics, chemistry, physics, auto mechanic, wood worker, artist, inventor, business man, ribald comedian, husband, brother, son, cat lover, cynic. I had a lot of fun. It was an honor for me to be friends with some truly great people. I thank you. I’ve had great joy living and playing with my dog, my cats and my parrot. But, the one special thing that made my spirit whole, is my long love and friendship with my remarkable wife, my beloved Mary Jane. I loved her more than I have words to express. Every moment spent with my Mary Jane was time spent wisely. Over time, I became one with her, inseparable, happy, fulfilled.

I enjoyed one good life. Traveled to every place on earth that I ever wanted to go. Had every job that I wanted to have. Learned all that I wanted to learn. Fixed everything I wanted to fix. Eaten everything I wanted to eat. My life motto was: “Anything for a Laugh”. Other mottos were “If you can break it, I can fix it”, “Don’t apply for a job, create one”. I had three requirements for seeking a great job; 1 – All glory, 2 – Top pay, 3 – No work.

Now that I have gone to my reward, I have confessions and things I should now say. As it turns out, I AM the guy who stole the safe from the Motor View Drive Inn back in June, 1971. I could have left that unsaid, but I wanted to get it off my chest. Also, I really am NOT a PhD. What happened was that the day I went to pay off my college student loan at the U of U, the girl working there put my receipt into the wrong stack, and two weeks later, a PhD diploma came in the mail. I didn’t even graduate, I only had about 3 years of college credit. In fact, I never did even learn what the letters “PhD” even stood for. For all of the Electronic Engineers I have worked with, I’m sorry, but you have to admit my designs always worked very well, and were well engineered, and I always made you laugh at work.

Now to that really mean Park Ranger; after all, it was me that rolled those rocks into your geyser and ruined it. I did notice a few years later that you did get Old Faithful working again. To Disneyland – you can now throw away that “Banned for Life” file you have on me, I’m not a problem anymore – and SeaWorld San Diego, too, if you read this.

To the gang: We grew up in the very best time to grow up in the history of America. The best music, muscle cars, cheap gas, fun kegs, buying a car for “a buck a year” – before Salt Lake got ruined by over population and Lake Powell was brand new. TV was boring back then, so we went outside and actually had lives. We always tried to have as much fun as possible without doing harm to anybody – we did a good job at that.

If you are trying to decide if you knew me, this might help… My father was RD “Dale” Patterson, older brother “Stan” Patterson, and sister “Bunny” who died in a terrible car wreck when she was a Junior at Skyline. My mom “Ona” and brother “Don” are still alive and well. In college I worked at Vaughns Conoco on 45th South and 29th East. Mary and I are the ones who worked in Saudi Arabia for 8 years when we were young. Mary Jane is now a Fitness Instructor at Golds on Van Winkle – you might be one of her students – see what a lucky guy I am? Yeah, no kidding.

My regret is that I felt invincible when young and smoked cigarettes when I knew they were bad for me. Now, to make it worse, I have robbed my beloved Mary Jane of a decade or more of the two of us growing old together and laughing at all the thousands of simple things that we have come to enjoy and fill our lives with such happy words and moments. My pain is enormous, but it pales in comparison to watching my wife feel my pain as she lovingly cares for and comforts me. I feel such the “thief” now – for stealing so much from her – there is no pill I can take to erase that pain.

If you knew me or not, dear reader, I am happy you got this far into my letter. I speak as a person who had a great life to look back on. My family is following my wishes that I not have a funeral or burial. If you knew me, remember me in your own way. If you want to live forever, then don’t stop breathing, like I did.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.